| A Case of Infrarenal Abdominal
Aneurysm Associated with Bilateral Internal Iliac Artery Aneurysms |
(Department of Cardiovascular Surgery, Hiroshima
City Hospital, Hiroshima, Japan)
| Koji Nakanishi |
Osamu Oba |
Takeshi Shichijo |
| Mikizo Nakai |
Keiji Yunoki |
|
|
Ischemic colitis is a serious complication
of abdominal aortic surgery. Patients with bilateral internal
iliac aneurysm have a high risk of ischemic colitis after operation.
A 72-year-old man had infrarenal abdominal aneurysm, bilateral
common and internal iliac aneurysm and an occluded right internal
iliac artery. We examined the flow of the superior rectal artery
during operation by transanal Doppler, and intramucosal pH of
the sigmoid colon by a tonometer after operation. The flow of
the superior rectal artery did not change after clamping of the
left common iliac artery, clamp of the infrarenal aorta. He underwent
uneventful abdominal aortic aneurysmectomy, Y-grafting and exclusion
of bilateral internal iliac aneurysms. The intramucosal pH of
the sigmoid colon returned to the normal range 25h after surgery.
He had no complications after surgery. Transanal Doppler examination
was essential for the successful prevention of postoperative
colonic ischemia, and intestinal intramural pH by tonometry was
an early reliable marker of the absence of ischemic colitis.
Jpn. J. Cardiovasc. Surg. 30: 197-199(2001) |
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